The Babysleep Doctor, Dr Brian Symon, is the co-researcher on new a research project this year, looking at infant sleep, feeding and growth. Details of the research, progress and preliminary results will be posted here. Stay tuned.
The Babysleep Doctor strategy is “evidence based”, meaning that there is research evidence that it works. Dr Symon has a PhD in infant sleep, feeding and growth having completed research funded by the research foundation of the Adelaide Women’s and Children’s Hospital in South Australia. It used a technique called a Randomised Controlled Trial or RCT, providing the “highest level of evidence” to establish its findings. His PhD found that:
- By 6 and 12 weeks, children in the intervention groups were sleeping an extra 9 hours per week compared to the children in the control groups.
- At five years of age there were no sleep differences between groups BUT there were no divorces in the intervention group.
The advice given in the research was provided by a single tutorial to the parents when the child was about three weeks old.
Download the full PhD here (379 pages, 1.1MB). Infant Sleep Disorders. Their significance and evidence-based strategies for prevention. A randomised Control Trial. By Dr Brian Symon.
Effect of a consultation teaching behaviour modification on sleep performance in infants: a randomised controlled trial.
Brian G Symon, John E Marley, A James Martin and Emily R Norman. MJA 2005; 182 (5):215-218
Up to 46% of parents report infant sleep problems. These include not sleeping through the night, delay in achieving sleep, and atypical behaviour at wakening. These sleep disturbances may have serious negative consequences, including postnatal depression, family breakdown and child abuse. Disturbances may be long-lasting, with one study finding that, based on parental reports, 41% of children with sleeping disturbance at eight months still had difficulties at three years.
Studies of sleep achievement show that all individuals, including babies, “learn” to fall asleep with certain external environmental cues. Sleep initiation is repeated several times during the night, as all individuals repeatedly awaken for brief periods. However, these awakenings and returns to sleep are usually not understood by parents. It has been suggested that parents can inadvertently contribute to unwelcome night crying when they rock, hold, pat or feed their infant to sleep. The child may learn to re-initiate sleep repeatedly by signalling (crying) for the parent to repeat similar behaviours.
Techniques of resolving sleep problems in infants and young children that have shown the best and most persistent results involve behaviour modification. Given the widespread nature of the problem and the potential for serious consequences, preventing sleep problems may be a superior strategy. Behavioural interventions have a well-reported efficacy in decreasing sleep disturbance from the time of birth. Given the frequency of these problems and their impact upon family life, a simple intervention available from primary care services would be of value.
This study evaluated the impact of a single consultation with a trained registered nurse recommending proven behaviour-modification approaches in improving sleep in newborns.
Download the complete article from the Medical Journal of Australia website.
Reducing postnatal depression, anxiety and stress using an infant sleep intervention.
Brian Symon, Michael Bammann, Georgina Crichton, Chris Lowings, James Tucsok. BMJ Open 2012; 2:e001662 doi:10.1136/bmjopen-2012-001662.
The objective of this research was to examine the psychological wellbeing of mothers following participation in a behavioural modification programme previously shown to improve infant sleep.
It involved a 45-minute consultation with either a general practitioner (GP) or trained nurse providing verbal and written information describing sleep physiology in infants and strategies to improve infant sleep. Eighty mothers of infants 6−12 months of age with established infant sleep problems at a single general practice, Adelaide, South Australia.
The results of the research were measured by the Depression Anxiety Stress Scale 21 (DASS21) immediately prior to the first consultation and again at follow-up approximately 3 weeks later. The number of infant nocturnal awakenings requiring parental support was also reported by mothers on both occasions.
The results of this research indicated that the number of nocturnal awakenings requiring parental support among infants aged 6−12 months significantly decreased following a single consultation on infant sleep physiology and teaching behavioural strategies to improve sleep. Significant improvements in maternal stress, anxiety and depression were also observed.
Read more at BMJ Open.
Feeding in the first year of life. Emerging benefits of introducing complementary solids from 4 months.
Brian Symon and Michael Bammann. Australian Family Physician. Volume 41. No 4. April 2012. Pages 226-229.
Current World Health Organization guidelines recommend exclusive breastfeeding for the first 6 months of life. Breastfeeding conveys clear benefits to both mother and child. These benefits are likely to be amplified by prolonged feeding.
This article outlines the emerging evidence that suggests possible benefits from introducing complementary solids from 4 months of age in developed countries.
The benefits of breastfeeding for infants and mothers are well proven. Recommendations to breastfeed exclusively for 6 months have been widely adopted by relevant organisations in Australia. These include the NHMRC,The Royal Australian College of General Practitioners, the Royal Australian College of Physicians and the Australian Breastfeeding Association.
The most robust evidence in favour of exclusive breast feeding for 6 months (EBF6) that the authors have been able to identify is lower risks of hospital admissions for gastroenteritis and lower respiratory tract infections (LRTIs). While in the developing world gastroenteritis is dangerous and often fatal, this is not the case in Australia, where effective and affordable medical advice is generally available. In addition, the risk for gastroenteritis has been linked to the introduction of formula milk rather than solids.
The authors support and applaud the benefits of breastfeeding, but little robust evidence exists in the scientific literature to show that the benefits of breastfeeding are lost or diminished by adding complementary solids from 4 months. Similarly, with the exception of certain infections, there is little robust evidence that the benefits are amplified by making breastfeeding exclusive.
- Breastfeeding offers many health benefits to both mother and child. The benefits are likely to be amplified by prolonging breastfeeding.
- Current literature does not provide a convincing argument on why exclusive breastfeeding is necessary to facilitate the many benefits of any breastfeeding in developed nations.
- There has been little public health promotion of the concept that all breastfeeding is desirable and beneficial to mother and child.
- Delayed exposure of the child to complementary solids may be a factor in the recent increase in food allergies in developed nations.
- There is an emerging body of evidence to suggest that there are benefits to introducing complementary foods from around 4 months and the authors recommend a return to a public health policy of exclusive breastfeeding for 4–6 months.
The authors wish to thank Dr Harriet Hiscock for commenting on manuscript drafts. Dr Hiscock is a paediatrician and postdoctoral research fellow at the Royal Children’s Hospital and Murdoch Childrens Research Institute.
Read the full article on the AFP website.